Publications by authors named "Antoni Gual"

Introduction: Alcohol-related problems increase the probability of frequent emergency department (ED) use. In this study, we compared the direct healthcare expenses incurred during a single visit among frequent and non-frequent ED users and analyzed the impact of alcohol-related issues in healthcare costs arising from ED usage.

Methods: The study relied on secondary analyses of economic data from a 1:1 matched case-control study with the primary aim of identifying the clinical characteristics of hospital ED frequent users in a Mediterranean European environment with a public, universal, and tax-funded health system.

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  • * A Delphi study involving 45 experts from Spain was conducted, utilizing an online survey to reach consensus on high-risk usage parameters based on a standardized measure called the Standard Joint Unit (SJU).
  • * The established consensus defined high-risk cannabis use as exceeding 4 SJU (over 28 mg THC) per week, or using cannabis with a potency greater than 10% THC.
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Introduction: Patients who make 5 or more visits per year to hospital emergency departments (EDs) are usually considered ED frequent users (FUs). This study aims to better characterize the influence of alcohol and other drug use-related disorders in this phenomenon in a European Mediterranean country with public, universal, tax-financed healthcare system.

Methods: Matched case-control study.

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Introduction: Attentional bias (AB) is an implicit selective attention toward processing disorder-significant information while neglecting other environmental cues. Considerable empirical evidence highlights the clinical implication of AB in the onset and maintenance of substance use disorder. An innovative method to explore direct measures of AB relies on the eye-movement activity using technologies like eye-tracking (ET).

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Objectives: Addressing substance use in psychiatric care encounters significant barriers, but the emergence of specialized services offers an opportunity to advance and scale up the integration of addiction services within psychiatric settings. However, research gaps still exist in this field, particularly in understanding the substance relapse rates of people with co-occurring disorders after a psychiatric hospitalization. This study aimed to investigate and compare the relapse rates of patients under inpatient care with exclusively addiction-related issues and those with co-occurring disorders after a hospitalization in a psychiatric ward and gain insights into differences in outcomes for these two patient groups.

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Background: Substance use trends are complex; they often rapidly evolve and necessitate an intersectional approach in research, service, and policy making. Current and emerging digital tools related to substance use are promising but also create a range of challenges and opportunities.

Objective: This paper reports on a backcasting exercise aimed at the development of a roadmap that identifies values, challenges, facilitators, and milestones to achieve optimal use of digital tools in the substance use field by 2030.

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Introduction: Training in addiction medicine and addiction psychology is essential to ensure the quality of treatment for patients with substance use disorders. Some earlier research has shown varying training between countries, but no comprehensive study of addiction training across Europe has been performed. The present study by the European Federation for Addiction Societies (EUFAS) aimed to fill this gap.

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Article Synopsis
  • The SCALA study found that training primary health care providers increased alcohol screening in Colombia, Mexico, and Peru, but both standard and shorter training sessions yielded similar results.
  • The research used a mixed-methods approach, collecting data from various sources to evaluate the impact of training on providers' alcohol screening practices.
  • Although participation was high, with nearly half of attendees screening for alcohol use, factors like the amount of training received and the provider's profession influenced the likelihood of conducting screenings, rather than satisfaction or perceived utility from the training.
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Lifetime prevalence of cannabis use is estimated 192 million adults worldwide (2017) and has increased by 16% in the last decade. However, data on quantity and frequency of use that can lead to harm is lacking. We have developed a survey to assess patterns of cannabis use and related harms in a sample of cannabis users.

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Aims: The estimated effect of sodium oxybate (SMO) in the treatment of alcohol dependence is heterogeneous. Population severity and treatment duration have been identified as potential effect modifiers. Population severity distinguishes heavy drinking patients with <14 days of abstinence before treatment initiation (high-severity population) from other patients (mild-severity population).

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  • * A study reviewed 10 relevant studies and found that consuming NoLo drinks can increase cravings and desire for alcohol in AUD patients, with more severe dependence correlating to greater craving.
  • * Heavy drinkers often consume NoLo drinks in addition to regular alcohol, rather than replacing it, highlighting the need for more research to inform treatment strategies for those with AUD and risky drinking patterns.
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Background: Passive exposure to the aerosols of electronic cigarettes (e-cigarettes) has been little studied. We assessed this exposure in late pregnancy in a woman and her 3-year-old child, exposed through e-cigarette use by another household member.

Methods: This prospective longitudinal case study involved a family unit consisting of an e-cigarette user, a pregnant woman who delivered an infant during the study, and the couple's older 3-year-old son.

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  • Chronic cannabis use may impact sensorimotor adaptation, a task related to cerebellar function, due to the high density of cannabinoid receptors in this part of the brain.
  • In a study, chronic users displayed lower adaptation rates compared to cannabis-naïve controls, but this difference disappeared after one month of abstinence.
  • The findings indicate that while cannabis use alters cerebellar learning initially, it may lead to changes in synaptic plasticity that equalize performance after a period of non-use.
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  • The SCALA project aims to improve the identification of alcohol use disorders and depression in primary healthcare settings in Colombia, Mexico, and Peru by implementing effective strategies that have yet to be widely adopted in low- and middle-income countries.
  • The process of developing the intervention involved a four-stage cultural adaptation model, which included gathering information, refining materials with stakeholder feedback, and pilot testing with local trainers.
  • Adaptations continued through real-world implementation, responding to challenges such as the COVID-19 pandemic by transitioning materials for online training delivery.
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Background: Sodium oxybate (SMO) has been shown to be effective in the maintenance of abstinence (MoA) in alcohol-dependent patients in a series of small randomized controlled trials (RCTs). These results needed to be confirmed by a large trial investigating the treatment effect and its sustainability after medication discontinuation.

Aims: To confirm the SMO effect on (sustained) MoA in detoxified alcohol-dependent patients.

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Purpose Of Review: The purpose of this update is to provide an overview of recent research publications (January 2020-January 2022) on real-time telemedicine solutions for the management of addictions (alcohol, tobacco, opioids, and other drugs).

Recent Findings: Motivational interviewing by real-time telemedicine showed effectiveness in youth and adults for risky alcohol use and alcohol use disorders, even when a concurrent mental health disorder exists. Live telemedicine is well accepted for managing tobacco use disorders.

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The crisis caused by prescribed opioids and their related side effects are a public health problem worldwide. Most of these are prescribed for coping with chronic pain. The coexistence of opioid use disorder (OUD) in patients with chronic pain represents a complex challenge due to the need for managing both pain and OUD.

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Issues: Numerous studies have examined the impact of the COVID-19 pandemic on alcohol use changes in Europe, with concerns raised regarding increased use and related harms.

Approach: We synthesised observational studies published between 1 January 2020 and 31 September 2021 on self-reported changes in alcohol use associated with COVID-19. Electronic databases were searched for studies evaluating individual data from European general and clinical populations.

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Article Synopsis
  • Brief alcohol advice can effectively prevent and manage alcohol-related health issues, but its implementation in primary healthcare is lacking.
  • To improve this implementation, community actions are proposed, focusing on enhancing the environment for healthcare providers.
  • The article outlines a protocol for these community actions in Colombia, Mexico, and Peru, which includes forming a Community Advisory Board, engaging a project champion, establishing support systems, and launching a communication campaign.
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